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Objectives: We looked at early pregnancy and parenthood as an opportunity to broaden our understanding of the reproductive health education needs met by adolescent girls. Methods: We conducted an in-depth interview study with 12 adolescent mothers. Results: To become a mother at a young age was perceived as meaningful to all the participants. The participants expressed a need to be addressed as adult parents, who want the best for their child. A variety of psychosocial and health needs emerged over a time span ranging from starting to be sexually active to after the child was born. Social isolation was found to be an important factor of vulnerability. Conclusion: The health needs of adolescent mothers extend well beyond counselling around the decision to continue or terminate pregnancy, and subsequent information on contraception methods to avoid further pregnancies. Adolescent mothers need to be supported in their transition to parenthood, and special care should be provided to girls who are socially isolated. Practice implications: We identified several avenues for health education and counselling to adolescent mothers, from primary prevention to reduce incidence of early pregnancies to tertiary prevention to reduce negative health outcomes for both mother and child. [Copyright &y& Elsevier]

Abstract: Objective: To quantify the age related risk of adverse obstetric outcome in primigravid women less than 20 years of age. Study design: The study sample was drawn from Cardiff Births Survey (a computerized maternity information database) comprising 66,271 pregnancies in the South Glamorgan region during 1990–1999. Pregnancy outcomes of primigravid women were compared in age groups less than 20 years (n =4126) and 20 to <35 years (n =17,615). SPSS version 11 was used for statistical analysis. Student''s t-test was used for continuous variables, Chi square, Fishers exact test was used for categorical variables. Results: There was a lower incidence of multiple pregnancies (OR=0.3(0.2–0.4)), spontaneous rupture of membranes >24h (OR=0.7(0.6–0.9)), and pregnancy-induced hypertension (OR=0.8(0.6–0.8)) amongst teenage primigravidae but a higher incidence of anaemia (OR=1.8(1.6–2.0)), and pyelonephritis (OR=1.5(1.1–2.0)). There was a lower incidence of induction of labour (OR=0.7(0.7–0.8)) and use of regional analgesia in the teenage group. Teenage women were more likely to have a spontaneous vaginal delivery (OR=2.1(2.0–2.3)) with a significantly lower incidence of instrumental delivery (OR=0.5(0.5–0.6)), and Caesarean section (OR=0.4(0.4–0.5)). Inspite of a higher incidence of preterm labour (corrected OR=1.4(1.1–1.7)) the perinatal outcome measures between the teenage group and the older group were not significantly different. Conclusion: Teenage primigravidae are more likely to have a spontaneous vaginal delivery, without compromising the maternal or neonatal outcome. [Copyright &y& Elsevier]

Abstract: Sub-Saharan Africa has one of the highest levels of teenage pregnancies in the world. In spite of that, there is paucity of empirical research on causes of teenage pregnancies in African countries. This paper investigates the determinants of teenage pregnancies based on a case study of Busia District in Kenya. The data are from a household survey conducted in 1998/1999. Empirical results indicate that girls’ education level has significant influence on the probability of teenage birth, with non-schooling adolescents and those with primary school level education being more vulnerable. Among the variables used as proxies for access to sex education, availability of church forums that educate adolescents about sex and family life issues reduce probability of teenage pregnancy. Age is positively related to teenage pregnancies, with older adolescents being more predisposed to pregnancies. Though use of contraceptives is found to have a positive effect, only a small proportion of adolescents were using modern contraceptives and, supply side factors such as quality and availability were not accounted for. Other key factors as outlined by the adolescents themselves include peer pressure and social environment-related factors like inappropriate forms of recreation, which act as rendezvous for pre-marital sex, as well as lack of parental guidance and counselling. Overall, lack of access to education opportunities, sex education and information regarding contraceptives, as well the widespread poverty predispose girls to teenage pregnancies. The problem of teenage pregnancies should be viewed within the broader socio-economic and socio-cultural environment in which the adolescents operate. For instance, lack of parental guidance on issues of sexuality and sex education was reinforced by cultural taboos that inhibit such discussions. Adolescents should be equipped with the relevant knowledge to enable them make informed choices regarding sexual relationships. This should be complemented with broader programmes aimed at promoting girl education and poverty alleviation. [Copyright &y& Elsevier]

Abstract: Introduction: One of the targets of national health programs is to prevent unintended pregnancies, especially among teenagers. It is well established that these often lead to abortion. Preventive programs aimed at decreasing abortion rates should identify target groups at risk for unintended pregnancies. Purpose: This study was conducted to determine whether young mothers under 20 years of age constitute a group at risk for new unintended pregnancies. Methods: A retrospective cohort study comprising teenagers giving birth to their first child from 1996 to 2000 was performed at Örebro University Hospital, Sweden. Data were collected from antenatal and medical records with particular regard to compliance with the postpartum visit and to whether a contraceptive method was prescribed. Information concerning repeat pregnancies during the 12 months after delivery was obtained. Results: A total of 250 deliveries were recorded; 70% of the mothers attended the postpartum visit, and 71% received contraceptive prescriptions. At the 12-month follow-up, 56 (25%) had a new pregnancy, and of those, 20 (36%) had a legal abortion, making the abortion rate fivefold higher than expected in this age group. Conclusion: This study shows that teenagers giving birth constitute a high-risk group for future unintended pregnancies and legal abortion. [Copyright &y& Elsevier]

• Young mothers' children face higher infant mortality than their later-born siblings. • The effect sizes are 48–81 % when comparing maternal ages 15−49 to ages 10−14 years. • In poor households, survival effects extend up to the fifth birthday. • In post-infancy, socio-economic factors compensate for biological disadvantage. • Adolescent pregnancies lead annually to estimated 18,700 under-5 deaths in Bangladesh. This paper examines the adverse effects of adolescent childbearing on early childhood mortality in Bangladesh in mother-fixed-effects regressions using individual mortality outcomes of 300,000 children. Children born to young mothers (child brides in Bangladesh) suffer from higher mortality in the first year of life than their siblings born later. The survival chances of children born to mothers aged 15−49 years are 48–81 % higher in infant period as compared to their siblings born in mother's early adolescence (10−14 years). In poor households, these survival effects extend up to the fifth birthday, especially in the poorest households or among uneducated mothers. This evidence points towards a biological channel, probably low birth weight, as the main contributing factor in the first year of life. In the post-infant period, favorable socio-economic factors (wealth, education) seem to compensate the biological disadvantage of adolescent births. Adolescent pregnancies lead annually to estimated 18,700 under-5 deaths in Bangladesh. [ABSTRACT FROM AUTHOR]